Bajaj Y, Bais AS, Mukherjee B (Lady Hardinge Med College, Delhi, India; SSK Hosp, Delhi, India; Kalawati Saran Children” Hosp, Delhi, India)
Tympanoplasty in children is debatable from success point of view.
J Laryngol Otol 112: 1147-1149, 1998.
Author did tympanoplasty type I in 45 children between 5 to 14 years. The presence of large perforation or cholesteatoma was ruled out. Preoperatively the ear was mandatory to be dry for 6 weeks. 91.1% was the success rate and did not depend upon the age. Better results were with underlay against the overlay technique.
Palva T, Ramsay H (Univ of Helsinki)
Chronic Inflammatory Ear Disease and Cholesteatoma : Creation of Auxiliary Attic Aeration Pathways by Microdissection
Am J Otol 20: 145-151, 1999
Attic compartment is aerated by the tympanic isthmus which gets blocked by chronic disease or cholesteatoma. Under these circumstances surgeons wishing to do intact canal wall technique have to areate the attic which is achieved by microdissection by Frontolateral attictomy which bypasses tympanic isthmus. This is interesting technique.
Rombout J, P auw BKH (Erasmus Univ, Rotterdam, The Netherlands)
Radical Revision Mastoidectomy for Chronic Otitis Media Without Cholesteatoma: The Revelance of Excenteration of All Rest Cells.
J Laryngol Otol 113 : 710-713, 1999
Discharging radical cavity after surgery, points to retained infected residual cells tracts or too small a meatus.
16 consecutive patients underwent Revision Radical Surgery to remove all the tracts by long patient surgical ablation. So also meatomy revised to create a large meatomy
The authors find it safe and useful to achieve dry cavity in 80% of cases.
M.M. Paparella agrees with the view but expects better results of 98% cases as in his series.